Pain Relief Patch Significantly Reduced Moderate to Severe Chronic Pain Interview with:
Peter Hurwitz
Clarity Science, LLC

Clarity Science Logo. (PRNewsFoto/Clarity Science)  What is the background for this study?

Response: Over the past several years, there has been a big push from healthcare professionals and patients to identify alternative pain management treatments and multimodal approaches that have been shown to have minimal side effects for those who experience mild to moderate and chronic pain conditions. These strategies may include non-pharmacological and pharmacological therapies. Topical therapies have been shown to address various pain conditions with minimal side effects as compared to oral over-the-counter (OTC) agents, prescription NSAIDs, and prescription opioids. T

his IRB-approved study evaluated whether a topical analgesic pain-relieving patch containing methyl salicylate (10%), Menthol (6%) and Camphor (3.1%) could reduce pain severity and improve function in patients over the course of 14 days.

Furry Social Robots May Provide Some Pain Relief

­ Interview with:

­ Shelly Levy-Tzedek, PhD
Head of the Cognition, Aging and Rehabilitation Lab
Faculty of Health Sciences, Dept. of Physical Therapy 
& The Zlotowski Center for Neuroscience
& ABC Robotics Initiative
The Ben Gurion University of the Negev

Prof. Levy-Tzedek  What is the background for this study?  What are the main findings?

Response: It is known that close, effective human touch can help alleviate pain. We set out to test whether touch interaction with a social robot can also reduce the sensation of pain. We found that it does: young, healthy people who touched the robot during the application of painful stimuli reported feeling less pain than when it was in the room with them (with no direct contact), or when it was not present at all. They also reported increased levels of happiness. 

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Which Older Adults Use Cannabis for Chronic Pain Relief? Interview with:
Julie Bobitt, PhD

Director, Interdisciplinary Health Sciences
University of Illinois at Urbana Champaign
Champaign, IL. 61820

Dr. Julie Bobitt
Dr. Julie Bobitt  What is the background for this study?

Response: Our previous research found that older adults, who we interviewed, used cannabis primarily for pain related reasons and that they were reporting using cannabis to reduce or altogether stop their use of opioids.  We wanted to further study this and we wanted to see if there were any differences between self-reported pain in non-cannabis users vs. cannabis users and then if there were differences between groups who used cannabis alone versus those who used opioids alone, versus cannabis in combination with opioids. 

Opioids Frequently Prescribed For Headache Pain Relief Interview with:
Richard B. Lipton, M.D.
Professor, The Saul R. Korey Department of Neurology
Professor, Department of Psychiatry and Behavioral Sciences
Professor, Department of Epidemiology & Population Health
Edwin S. Lowe Chair in Neurology
Vice Chair The Saul R. Korey Department of Neurology
Director, Montefiore Headache Center
Albert Einstein College of Medicine  What is the background for this study

Response: Almost everyone with migraine takes acute treatments at the time of attacks to relieve pain and restore function.  Acute treatments include over-the-counter medications. prescription drugs and devices.  The most widely used prescription drugs for migraine are triptans (such as sumatriptan and rizatriptan) and NSAIDs (such as ibuprofen and naproxen). 

Richard B. Lipton, M.D. Professor, The Saul R. Korey Department of Neurology Professor, Department of Psychiatry and Behavioral Sciences Professor, Department of Epidemiology & Population Health Edwin S. Lowe Chair in Neurology Vice Chair The Saul R. Korey Department of Neurology Director, Montefiore Headache Center Albert Einstein College of Medicine
Dr. Lipton

Opioids are not recommended in treatment guidelines as acute treatments for migraine.  Longitudinal studies show that in people with migraine treatment with opioids is associated with dose dependent acceleration of headache frequency and the development of chronic migraine in people with episodic migraine.  The purpose of this study was to determine the relative frequency of opioid use and the characteristics of those who use opioids to treat migraine. The hope is to use this information to develop programs which will encourage guideline compliant treatment.

Studies Find Plant-Based Spray Can Provide Pain Relief from Inflammatory Skin Conditions Interview with:
Medical Director in Pierre Fabre Group.

Markéta SAINT AROMAN, MD  What is the background for this study?  What are the main findings?

Response: Patients with inflammatory skin diseases frequently experience cutaneous pain as a symptom of their disease and may also experience burning and stinging sensations.

Signs and symptoms of inflammation are also experienced by patients who have undergone therapeutic and aesthetic skin resurfacing procedures (such as laser treatment, chemical peels and photodynamic therapy).

Diseases such as eczema (atopic dermatitis (AD), hand eczema) and psoriasis and dermatological procedures are all associated with disruption to the skin barrier which can expose cutaneous nerve endings, which are responsible for transmitting sensory information including itch and pain and increase sensitivity to environmental irritants. Heat sensations and oedema associated with inflammation also activate pain receptors. The impulse to scratch, which is a feature of AD and psoriasis and also occurs during the healing process following dermatological procedures, is a cause of cutaneous pain. At a molecular level, inflammation is characterized by the release of prostaglandins, cytokines, chemokines, proteases, neuropeptides, and growth factors, which are known to act directly on peripheral pain-sensing neurons.

The efficacy of the spray used in the study may be explained by the inclusion of two plant extracts demonstrated to have anti-inflammatory, immunomodulatory and antalgic activities.
The oat plantlet extract contains immumomodulatory saponins and anti-inflammatory flavonoids which inhibit the production of inflammatory mediators and stimulate keratinocyte proliferation and skin barrier repair. 

The extract of Uncaria tomentosa contains active compounds targeting peripheral pain sensation pathways.

Back Pain: Web-Based Self-help Intervention to Prevent Depression Interview with:

Lasse B. Sander, PhD
Institute of Psychology
Department of Rehabilitation Psychology and Psychotherapy
Albert-Ludwigs-University of Freiburg
Freiburg, Germany

Lasse B. Sander, PhD
Institute of Psychology
Department of Rehabilitation Psychology and Psychotherapy
Albert-Ludwigs-University of Freiburg
Freiburg, Germany
Dr. Sander  What is the background for this study?  What are the main findings?

Response: People with chronic pain have a significantly increased risk of developing depression. When depression and pain collide, this is a considerable burden for those affected. In addition, pain management is made more difficult due to comorbidity.

We have known for some years now that the onset of depression can be delayed or even completely prevented by means of early psychological therapies. However, until now there has been no scalable application option available for routine healthcare.

In our study we were able to show that this can be achieved by a digital self-help intervention.

Trial of Desipramine, Cognitive Behavioral Therapy, and Placebo for Low Back Pain Relief Interview with:
Thomas Rutledge, PhD, ABPP
Staff Psychologist, VA San Diego Healthcare System
Professor of Psychiatry
UC San Diego  What is the background for this study?

Response: The goal of this study was to combine our team’s pharmacy, psychiatry, and psychology expertise with chronic pain to conduct a rigorous, head-to-head efficacy trial. The clinical trial literature for chronic back pain is enormous. On the surface, this literature suggests that many medication and pain psychology treatments are effective by standards of statistical significance. These findings are difficult to interpret, however, because there are few trials comparing statistically effective chronic back pain treatments with active control treatments and nearly no trials randomizing patients with chronic back pain to medication versus pain psychology treatments. We hoped that our trial could offer data to help fill these gaps. Mindful of the increasing concerns about long-term opioid use for chronic pain, we also believed the study could have value by focusing on non-opioid agents (Desipramine) and cognitive behavioral therapy.

Study of Daily CBD for Pain Relief of Canine Osteoarthritis Interview with:
Matthew Halpert, Ph.D., B.S
Baylor College of Medicine  What is the background for this study?

Response: The background will actually encompass my disclosure.  A little over a year ago, Medterra was one of a couple of CBD companies that approached me about conducting some small scale studies focused on CBD and its anti-inflammatory properties.  It became very obvious, very quickly that some (most) companies were not interested in actual science or data, but rather just wanted to try and increase their CBD-fad based revenue by using my name and affiliations. Medterra proved to be very different and genuinely wanted legitimate data and science to support and direct products, innovations, stories etc.  I always warned them that the ‘data will be the data’ and they agreed to live by that….even if the data wasn’t as supportive as they may have hoped.  Being a true academic researcher, I found this to be more than acceptable and Medterra and Baylor College of Medicine entered into a Sponsored Research Agreement (SRA) in which Medterra provides product and money for research, and my lab performs the research and reports back the data.

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Hemp Oil Studies for Pain Relief of Neuropathic Pain Interview with:
Karin Westlund High, PhD
Professor and Vice-Chair for Research
Department of Anesthesiology & Critical Care Medicine
University of New Mexico Health Sciences Center
Albuquerque, NM 87106 What are the main findings?

Response: Nearly 1 in 5 Americans recently reported that their level of pain interferes with their daily lives. Treatment options for persons with chronic pain are not optimal, particularly opioid therapies found to exacerbate pain or become ineffective over time in patients and in animal studies. While some have turned to marijuana to relieve pain where it has been legalized, benefits of the pain relieving cannabinols are not suitable for many given the psychotropic effects of its tetrahydrocannabinol (THC) content.

The Hemp Farming Act in 2019 effectively began legal cultivation in some states of a variety of the Cannabis plant—conventionally referred to as ‘hemp’. The primary components of hemp are the pain relieving cannabidiol (CBD) chemicals, differing from the content in their federally illegal counterparts which contain levels over 0.3% of the psychoactive THC. In  fact, it is reported that the content of CBD was bred down while THC bred up in marijuana seized in California  between 2001-2008.

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Review of Compounded Topical Creams for Pain Relief Interview with:

Debra A. Schwinn, M.D. (Committee Chair) – President-Elect of Palm Beach Atlantic University; former professor of anesthesiology, pharmacology, and biochemistry at the University of Iowa

Edmund J. Elder, Ph.D., R.Ph. – Director of the Zeeh Pharmaceutical Experiment Station, School of Pharmacy at the University of Wisconsin–Madison

·John T. Farrar, M.D., Ph.D. -Associate Professor of epidemiology and neurology, University of Pennsylvania School of Medicine  What is the background for this study?

Response: Compounding is the process of altering or combining ingredients to create medications that are tailored for an individual. Typically, compounded topical pain creams – which are applied to the skin in the form of gels, lotions, or ointments – are used by patients who cannot tolerate oral pain medications.

However, compounded topical preparations are not subject to the same level of extensive testing and stringent regulatory oversight as FDA-approved products. There are a number of safety concerns associated with their use, ranging from minor skin irritations to drug toxicity.

In response, FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to make recommendations for how the available scientific data on safety and effectiveness should inform future prescribing decisions. What are the main findings?

Response: The report found there is limited scientific evidence to support the safety and effectiveness of compounded topical pain creams in adults. The committee assessed 20 Active Pharmaceutical Ingredients (APIs) that are commonly used in compounded topical pain creams. Out of the 20 APIs reviewed, 3 individual APIs and 1 two-drug combination demonstrate potential clinical effectiveness in compounded topical pain creams.

When possible, providers should prescribe FDA-approved products. Pharmacists and providers who prescribe compounded topical pain creams should also educate their patients about how much to use, which conditions to use it for, and the potential risks.

Among the report’s other findings about safety and effectiveness:

·         The rate and extent of the drug’s absorption into the skin and beyond is often unknown

·         There is no clear clinical rationale for specific combinations of APIs and dosages used

·         Labeling requirements for compounded preparations are often inadequate

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